The Ketogenic diet is started in hospital, under medical supervision, with a starvation period. Once the child has achieved large tetonuria the diet is gradually introduced. The diet supplies nine times as many calories from fat as from protein and carbohydrates combined. It requires a constant need to weigh, measure, and strictly control the food consumption, since even very small amount of carbohydrate may eliminate the desired ketosis and nullify any beneficial effect. Fluids are also restricted.